| Sfvcmhc Evyfc | |
|
6400 Laurel Canyon Blvd Suite 500 North Hollywood CA 91606-1571 | |
| (818) 901-6376 | |
| (818) 904-9273 |
| Full Name | Sfvcmhc Evyfc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 6400 Laurel Canyon Blvd, North Hollywood, California |
| Authorized Official Name and Position | Timothy Ryder (PRESIDENT) |
| Authorized Official Contact | 8189014830 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sfvcmhc Evyfc 16360 Roscoe Blvd Suite 200 Van Nuys CA 91406-1219 Ph: (818) 901-4830 | Sfvcmhc Evyfc 6400 Laurel Canyon Blvd Suite 500 North Hollywood CA 91606-1571 Ph: (818) 901-6376 |
| NPI Number | 1013047422 |
|---|---|
| Provider Enumeration Date | 03/06/2007 |
| Last Update Date | 02/04/2020 |
| Certification Date | 02/04/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013047422 | NPI | - | NPPES |
| 000006853 | Other | CA | MEDICAL PROVIDER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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